During an outbreak of diphtheria among alcoholics in Göteborg, Sweden, a study was made of the diphtheria-antitoxin antibodies in serum samples from 8 clinical cases and 36 carriers of toxin-producing Corynebacterium diphtheriae. 33/36 carriers were antibody-positive and had antitoxin titres greater than 0.01 IU/ml, a level which is regarded as relative protective, while only 1/8 clinical cases had such a titre. This patient presented a mild illness with no complications. The results of the study of this outbreak stress the importance of maintaining adequate antibody levels against diphtheria in highly developed societies.

No abstract

After 25 years without any indigenous cases of diphtheria in Sweden, an outbreak occurred in the city of Göteborg, during 1984 to 1986. A group of alcoholics constituted the reservoir of Corynebacterium diphtheriae. The outbreak included 13 clinical cases and 65 carriers. The death-to-case ratio and the complication rate among the clinical cases was high, with three fatal cases and six patients developing reversible paralyses. The fatal cases had no history of previous immunization. The outbreak demonstrates the necessity of a good vaccination status to diphtheria, also in countries where the disease was thought to have been eradicated.

No abstract